Title: 0146 - Smoking Trajectories during Pregnancy and Postpartum in North Central Appalachia


Matthew Arias (Presenter)
West Virginia University

Casey Wright, West Virginia University
Daniel McNeil, West Virginia University
Elizabeth Kao, West Virginia University
Linda Alexander, West Virginia Univeristy
Katherine Neiswanger, University of Pittsburgh
Robert Weyant, University of Pittsburgh
Betsy Foxman, University of Michigan
Richard Crout, West Virginia University School of Dentistry
Mary Marazita, University of Pittsburgh


Objectives: Pregnancy is a time that many women focus on health behaviors that affect the fetus; for example, discontinuing use of substances such as tobacco, which is associated with negative birth outcomes, including low birth weight, pre-term birth, and orofacial clefts. However, women may resume smoking postpartum, despite risks to children when exposed to second hand smoke. Understanding trajectories of tobacco use during and following pregnancy is needed to design appropriate interventions.

Methods: Data were collected as part of a longitudinal study by the Center for Oral Health Research in Appalachia, focusing on biopsychosocial contributors to oral health outcomes of pregnant women and their children. Smoking behavior reported during pregnancy and postpartum from 1,131 women living in Northern Appalachia (i.e., West Virginia and Pennsylvania) was analyzed by latent class growth modeling to identify smoking trajectories across five time-points (i.e., during pregnancy and at 6, 12, 18, and 24 months postpartum).

Results: Three distinct classes of smoking trajectories were identified. A “non-smoking” group (n=876, 77.4%) included women who did not smoke during pregnancy or postpartum. A “rebound” group (n=114, 10.1%) was comprised of women who abstained from smoking during pregnancy but reinstituted it postpartum. An “amplified” group (n=141, 12.5%) was women who reported smoking during pregnancy and increased their smoking behavior postpartum.

Conclusions: Tobacco use can result in negative outcomes, so it is important to know when to target perinatal/postnatal women. Results suggest an important time-point for smoking cessation treatment is during pregnancy. For women within the “rebound” group, it is crucial to inoculate them during pregnancy about maintaining healthy behaviors after childbirth, as it may be easier to maintain abstinence than to decrease/stop reinstated smoking behavior. Those who reinstate smoking after childbirth present another important time-point for intervention. Future research should focus on determining interventions to use at critical time-points with perinatal/postpartum women. R01-DE014889.

This abstract is based on research that was funded entirely or partially by an outside source:
National Institute of Dental and Craniofacial Research R01-DE014889.

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE

Sponsoring Group/Network